1980, 12-11 Permit: 80B-4750 PipingIPLAN NUMBER .. APPLICATION/PERMIT P ERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT `� - '���
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
ADDRESS ZIP Main Floor I Upper Floors Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPENEW ALT. ❑ AD'N. El RPL. El MVE.
No. Baths No. Stories No. Rooms No. of Dwellinc
❑
7, OF11OTHER
WORK 1:1 BLD. 1-1PLMB. I/MECH. ❑ M. H. ❑ POOL CERTIFICATE Req'd. I Recd. Not Req'c
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
8, P1I VAI' FEES COLLECTED
VALUATION SOURCE AS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES
Public ❑Private ❑ Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION Plumbing
DATE OF APPLICATION -- O v SIGNATURE OF APPLICAN ech. w ' 670y
/
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
in Te clan PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify) -
TOTAL $0-
C 0
C4* *h00
*6.00
A r
4749
12-11-00
6,479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1
12r.1-1 47 0Z,
nATF ISSI IFn oconnr nin
*600ao--
TnTA i
C
C
4
APPLICANT: COMPLETE NUMBERED SPACES - PRESS
HARD TO MAKE 3 COPIES
JOB A DRESS
/
54n"
LEGAL DESCRIPTION - SEE ATTACHED
LOT I
BLOCK
IS IJBIVISION
PARCEL NUMBER/S
2.
OWNER
J
J -
PHONE
'���
3.
. .
ADD
SS
���
- ' `
175!• !
Actual Set Backs in Feet
CONTR CT
R
`
PHONE
North South
Size of Parcel
East West
Zone Classification
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS ZIP Main Floor I Upper Floors Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPENEW ALT. ❑ AD'N. El RPL. El MVE.
No. Baths No. Stories No. Rooms No. of Dwellinc
❑
7, OF11OTHER
WORK 1:1 BLD. 1-1PLMB. I/MECH. ❑ M. H. ❑ POOL CERTIFICATE Req'd. I Recd. Not Req'c
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
8, P1I VAI' FEES COLLECTED
VALUATION SOURCE AS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES
Public ❑Private ❑ Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION Plumbing
DATE OF APPLICATION -- O v SIGNATURE OF APPLICAN ech. w ' 670y
/
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
in Te clan PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify) -
TOTAL $0-
C 0
C4* *h00
*6.00
A r
4749
12-11-00
6,479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1
12r.1-1 47 0Z,
nATF ISSI IFn oconnr nin
*600ao--
TnTA i
C
C
4